Why nostrils become visible and nasal bridge volume is lost after multiple surgeries

Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who underwent revision rhinoplasty to correct nasal deformities caused by multiple previous surgeries and to achieve a more defined aesthetic.

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• 8 years ago: Revision rhinoplasty

• September 2019: Revision rhinoplasty (nasal deformity developed - bulbous nose + drooping tip)

• 2020: Donor rib cartilage and silicone implant

• 2021: Ear cartilage

• January 2024: Autologous rib cartilage + silicone implant

• Improve excessive nostril show on the front view

• Desire to raise the nasal tip

• Improve height in the glabella region

• Address lack of volume on the left side of the nasal bridge

• Desires a natural outcome without an operated look on the front view

• Prefers a nose with well-defined volume

*During thorough preoperative evaluation and detailed examination, structural changes and functional issues from previous surgeries were identified, with weakened tip support and asymmetry noted as the primary areas for improvement.

1. Structural reconstruction

• Recycled the existing autologous rib cartilage

• Supplemented with donor rib cartilage

• Reinforced the nasal tip support strut

2. Improving symmetry

• Balanced the nasal tip while taking into account alar asymmetry caused by previous alar reduction

• Carefully adjusted columellar height

• Refined the nasal bridge line, reinforcing depressed areas with cartilage and dermal grafts

3. Enhancing functional stability

• Performed bilateral nostril correction

• Reinforced the soft triangle area using a composite skin graft

• Applied a skin graft to the columellar region

This case required resolving complex issues caused by multiple previous surgeries. When the number of previous surgeries is high, I generally recommend focusing on a stable structure and a natural shape. However, the patient's preferences were clear, so we worked to achieve the desired contour while keeping safety the top priority. In particular, structural stability was established by appropriately utilizing autologous and donor tissues, leading to a pleasing aesthetic result.

This was Dr. Peter C. Kang. Thank you.

Thank you.

#closedrhinoplasty #revisionrhinoplasty #tiprhinoplasty #bulbousnoserevision #naturalrhinoplasty #customrhinoplasty